Provider Demographics
NPI:1891964631
Name:POINT PLEASANT HORSHAM, LP
Entity Type:Organization
Organization Name:POINT PLEASANT HORSHAM, LP
Other - Org Name:POINT PLEASANT PEDIATRIC SPECIAL CARE AT HORSHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-297-5555
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:90 CAFFERTY RD.
Mailing Address - City:POINT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:18950-0217
Mailing Address - Country:US
Mailing Address - Phone:215-297-5555
Mailing Address - Fax:215-297-0918
Practice Address - Street 1:3938 GLEN DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-5436
Practice Address - Country:US
Practice Address - Phone:215-297-5555
Practice Address - Fax:215-297-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA131650251J00000X
PA131660251J00000X
PA131760251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020766550001Medicaid